危重症患者早期肠内营养喂养中断发生率及影响因素的Meta分析

The incidence and influencing factors of early enteral nutritional feeding interruptions in critically ill patients:a meta-analysis

目的系统评价危重症患者早期肠内营养喂养中断的发生率及影响因素。方法计算机检索PubMed、Web of Science、Embase、Cochrane Library、CNKI、WanFang Data和CBM数据库,搜集关于危重症患者早期肠内营养喂养中断的观察性研究,检索时限均为建库至2024年1月2日。由2名研究者独立完成文献筛选、提取资料及纳入文献的偏倚风险评价后,采用Stata 17.0软件进行Meta分析。结果共纳入12个研究,包括1121例患者。Meta分析结果显示,危重症患者早期肠内营养喂养中断的发生率为75.0%[95%CI(64.0%,84.0%)]。受喂养不耐受、气道管理、管道问题、放射学检查、内镜检查、手术等因素的影响,危重症患者早期肠内营养喂养中断发生较频繁。结论当前证据显示,危重症患者早期肠内营养喂养中断受多种因素影响,且发生率较高。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。

Objective To systematically review the incidence and influencing factors of early enteral nutritional feeding interruptions in critically ill patients.Methods The PubMed,Web of Science,Embase,Cochrane Library,CNKI,WanFang Data and CBM databases were electronically searched to collect observational studies on the early enteral nutritional feeding interruptions in critically ill patients from inception to January 2,2024.Two reviewers independently screened literature,extracted data and assessed the risk of bias of the included studies.Meta-analysis was then performed by using Stata 17.0 software.Results A total of 12 studies including 1121 patients were included.Meta-analysis showed that the incidence of early enteral nutritional feeding interruptions in critically ill patients was 75.0%(95%CI 64.0%to 84.0%).Influenced by feeding intolerance,airway management,tube problems,radiological examination,and endoscopy,surgery and so on,interruptions of early enteral nutritional feeding frequently occur in critically ill patients.Conclusion Current evidence shows that early enteral feeding interruptions in critically ill patients are affected by many factors,and the incidence is high.Due to the limited quality and quantity of the included studies,more high-quality studies are needed to verify the above conclusion.